<form id="form" name="form" action="process.php" method="post" autocomplete="off" >
	<input type="hidden" name="subjoin" value="1">
	<fieldset><legend>Login Information</legend>
		<ul>
			<li id="li_user"><label id="label_user" for="user">Username</label>
				<input id="user" type="text" name="user" size="30" class="medium user" maxlength="30" value="" />
				<span id="userInfo">Must Be At Least 4 Characters</span>
			</li>
            <li id="li_pass"><label id="label_pass" for="pass">Password</label>
                <input id="pass" type="password" name="pass" class="medium pass" onkeyup="passwordStrength(this.value)" size="30" maxlength="30" value="" />
                <span id="passInfo">Must Be At Least 8 Characters</span>
                <label id="passStrength" class="strength" ></label>
            </li>
            <li id="li_conf_pass"><label id="label_conf_pass" for="conf_pass">Confirm Password</label>
                <input id="conf_pass" type="password" name="conf_pass" class="medium pass" size="30" maxlength="30" value="" />
                <span id="conf_passInfo">Must Match Password Entered Above</span>
            </li>
		</ul>
	</fieldset>
	<fieldset><legend>Personal Information</legend>
        <ul>
            <li id="li_firstName"><label id="label_first" for="firstName">First Name</label>
            <input id="firstName" type="text" name="firstName" class="medium alpha" size="30" maxlength="32" value="" />
            </li>
            <li id="li_lastName"><label id="label_lastName" for="lastName">Last Name</span></label>
            <input id="lastName" type="text" name="lastName" class="medium alpha" size="30" maxlength="32" value="" />
            </li>
        </ul>
	</fieldset>
    <fieldset><legend>Contact Information</legend>
        <ul>
            <li id="li_phoneNumber"><label id="label_phoneNumber" for="phoneNumber">Phone Number</label>
                <input id="phoneNumber" type="text" size="30" class="medium phone" name="phoneNumber" placeholder="(___) ___-____ x____" value=""/>
                <span id="phoneNumberInfo">Please Include Extension If Applied</span>
            </li>
            <li id="li_email"><label id="label_email" for="email">Email</span></label>
                <input id="email" type="text" name="email" class="medium email"  size="30" maxlength="50" value="" />
            	<span id="emailInfo">Must Be A Valid Email Address</span>
            </li>
            <li id="li_conf_email"><label id="label_conf_email" for="conf_email">Confirm Email</label>
                <input id="conf_email" type="text" name="conf_email" size="30" class="medium email" maxlength="50" value="" />
                <span id="conf_emailInfo">Must Match The Email Entered Above</span>
            </li>
        </ul>
    </fieldset>
	<input id="submit" class="button big" type="submit" name="Register" value="Register" />
    <!--<fieldset><legend>Organization Selection</legend>
    <ul>
    <li><label class="description" for="orgs"><span class="description_label">Please select an organization that you are a part of. If your organization is not in the system, please register your organization.</span></label>
    <div>
    <?php
    // Write out our query.
    $query = "SELECT orgID, orgName FROM organizations ORDER BY orgName";
    // Execute it, or return the error message if there's a problem.
    $result = mysql_query($query) or die(mysql_error());
    $dropdown = "<select id='orgs' name='orgs' class='xlarge' onchange='showOrg(this.value)'>
        <option value=''>Select an option...</option>
        <option value='new'>New Organization</option>";
    while($row = mysql_fetch_assoc($result)) {
    $dropdown .= "\r\n<option value='".$row['orgID']."'>".$row['orgName']."</option>";
    }
    $dropdown .= "\r\n</select>";
    echo $dropdown;?>
    </div>
    </li>
    </ul>
    </fieldset>
    <div id="txtHint"></div>
    <fieldset><legend>Verification</legend>
    <ul>
    <li id="li_captcha">
    <?php 
    if ($config['ENABLE_CAPTCHA']){
    echo "<tr><td colspan=\"2\"><div class=\"QapTcha\"></div></td></tr>";
    }?>
    </li>
    </ul>
    </fieldset>-->
<!-- The following div tag displays a hidden form field in an attempt at tricking automated bots. -->
<div style='display:none; visibility:hidden;'><input type='text' name='killbill' maxlength='50' /></div>
</form>